SB206: Bill Text

LRB-2833/1

TJD:jld&cjs:rs

2011 - 2012 LEGISLATURE

2011 Senate BILL 206

September 28, 2011 - Introduced by Senators Erpenbach, Carpenter, S. Coggs, Hansen, Holperin, Jauch, C. Larson and Taylor, cosponsored by Representatives Richards, Pasch, Berceau, Bernard Schaber, Bewley, Clark, E. Coggs, Grigsby, Hebl, Hintz, Milroy, Pocan, Pope-Roberts, Roys, Seidel, Sinicki, C. Taylor, Toles and Turner. Referred to Committee on Insurance and Housing.

SB206,2,4 An Act to repeal 631.95 (3) (a), 632.746 (1) (b), 632.746 (2) (a) and (b), 632.746 (2) (c), (d) and (e), 632.746 (2) (dm), 632.746 (3) (a), 632.746 (3) (d) 2. and 3., 632.746 (10) (a) 4., 632.7497 (3) (b), 632.76 (2) (ac) 2., 632.76 (2) (ac) 3., 632.76 (2) (ac) 4., 632.895 (15) (c) 1. to 4. and 632.895 (15) (c) 6.; to renumber 632.746 (3) (d) 1. and 632.7497 (3) (a); to renumber and amend 632.746 (1) (a), 632.76 (2) (ac) 1., 632.895 (13) (a) and 632.895 (15) (a); to amend 40.51 (8), 40.51 (8), 40.51 (8m), 40.51 (8m), 66.0137 (4), 66.0137 (4), 120.13 (2) (g), 120.13 (2) (g), 185.983 (1) (intro.), 185.983 (1) (intro.), 609.22 (3), 609.845, 625.12 (1) (a) and (e), 625.12 (2), 625.15 (1), 628.34 (3) (a), 631.11 (4) (a) and (b), 631.22 (2), 631.22 (5), 632.746 (5) (a), 632.746 (8) (a) (intro.), 632.746 (10) (a) 1., 632.76 (2) (a), 632.76 (2) (ac) 1., 632.76 (2) (ac) 2., 632.76 (2) (ac) 3. (intro.), 632.76 (2) (b), 632.795 (4) (a), 632.85 (2), 632.883 (2), 632.895 (15) (b), 632.895 (15) (c) 5., 632.897 (11) (a) and 635.02 (2); and to create 609.845, 632.723, 632.7252, 632.7254, 632.728, 632.746 (2) (dm), 632.7493, 632.753, 632.758, 632.76 (2) (ac) 4., 632.85 (4), 632.865, 632.87 (5m), 632.883, 632.895 (13) (a) 2., 632.895 (13) (a) 3., 632.895 (13) (c), 632.895 (13m), 632.895 (15) (a) 1., 2. and 3., 632.895 (15) (d) and 632.895 (15) (e) of the statutes; relating to: implementing federal health insurance law changes.

Analysis by the Legislative Reference Bureau

On March 23, 2010, the federal government enacted the Patient Protection and Affordable Care Act (PPACA), which, among other things, imposes requirements and limitations on health insurance policies and health plans. This bill incorporates some of those requirements and limitations of PPACA into state law.

Under current law, no insurer may rescind an insurance policy for a misrepresentation made by a policyholder if the insurer had constructive or active knowledge of the fact. An insurer may rescind a policy if it acquires knowledge of sufficient facts to constitute grounds for rescission after the policy was issued only if the insurer notifies the insured within 60 days after acquiring the knowledge of its intent to rescind or within 120 days if the insurer needs to gather additional medical information. This bill prohibits an insurer from rescinding a health benefit plan, or a self-insured governmental health plan from recinding a self-insured plan, unless the applicant for coverage committed fraud or made an intentional misrepresentation of material fact with regard to obtaining coverage. The insurer or governmental entity must provide notice before rescinding the plan.

Under current law, a policy or plan providing individual health insurance may not reduce or deny coverage based on a preexisting disease or condition (preexisting condition exclusion) after 12 months after the date of issue of the policy or plan unless the condition was specifically excluded from coverage. The preexisting condition that is excluded from coverage must have been one for which the individual received or was recommended medical advice, diagnosis, care, or treatment within 12 months before the coverage under the plan became effective. A group health benefit plan, under current law may impose a preexisting condition exclusion on an individual's coverage only if the condition being excluded was one for which the individual was recommended or received medical advice, diagnosis, care, or treatment within six months before the individual's enrollment date under the plan. This bill prohibits an insurer under a group health benefit plan or an individual health insurance policy, except for a grandfathered health plan providing individual health coverage, from imposing a preexisting condition exclusion on a participant or beneficiary under the plan who is under 19 years of age. A grandfathered health plan is a health policy or plan in existence on March 23, 2010. As of January 1, 2014, this bill prohibits an insurer that offers a group health benefit plan or an individual health insurance policy, except for a grandfathered health plan providing individual health coverage, from imposing a preexisting condition exclusion on any participant or beneficiary under the plan, regardless of age.

Under the bill, every group health plan, except for a grandfathered health plan, and every insurer providing a health insurance policy, and every self-insured governmental health plan must provide coverage for all preventive care services as defined in PPACA. The bill prohibits a plan or insurer from subjecting the coverage of a preventive care service to a copayment or coinsurance.

This bill requires an individual or group health plan, except a grandfathered health plan, to provide in plain language to the secretary of the federal department of health and human services (DHHS), the commissioner of insurance, any insurance exchange if the plan is sold through an exchange, and the public certain disclosures including claims payment policies and practices, data on enrollment and disenrollment in the plan, and enrollee and participant rights. A health benefit plan, except a grandfathered health plan, is also required to make available upon request on its Internet Web site, and through another means for those without Internet access, a means to permit individuals to learn the amount of cost sharing required under the plan for a specific item or service.

This bill requires that a group or individual health benefit plan, except for a grandfathered health plan, that requires or provides for an individual or beneficiary to designate a primary care provider must allow each individual or beneficiary to designate any participating primary care provider who is available to accept that individual or beneficiary.

Under current law, a health care plan or a self-insured governmental health plan that provides coverage of any emergency medical services must provide coverage of emergency medical services that are provided in a hospital emergency facility and that are needed to evaluate or stabilize an emergency medical condition. Current law prohibits the health care plan or self-insured governmental health plan from requiring prior authorization for those emergency medical services. This bill specifies that the services must be covered regardless whether the hospital emergency facility is a participating provider in the health care plan or self-insured governmental health plan. This bill also requires that the health care plan or self-insured governmental health plan, except for a grandfathered health plan, impose the same cost-sharing requirements on coverage for emergency medical services provided by a nonparticipating provider as it imposes for a participating provider.

With some exceptions, this bill prohibits a self-insured governmental health plan or a health care plan, except for a grandfathered health plan, from restricting benefits for a hospital stay for a mother or newborn to less than 48 hours for a vaginal delivery or less than 96 hours for a cesarean section.

Under current law, every health insurance policy and self-insured governmental health plan that provides coverage of mastectomies must provide coverage of breast reconstruction of the affected tissue incident to a mastectomy. The policy or plan may impose cost-sharing provisions on the breast reconstruction coverage that apply generally under the policy or plan. This bill specifies that all stages of breast reconstruction must be covered by a policy or plan. Under the bill, the policy or plan must also cover surgery and reconstruction of the other breast than the one on which the mastectomy was performed to produce a symmetrical appearance and prostheses and physical complications of mastectomy. The bill also specifies that all procedures covered must be provided in a manner determined in consultation with the attending physician and the patient. A policy or plan is required under the bill to provide written notice of the available coverage upon enrollment in the policy and annually thereafter.

Under current law, every health insurance policy and every self-insured governmental health plan that provides coverage for a full-time student dependent of the insured, must continue to provide coverage for that dependent if, due to a medically necessary leave of absence, the dependent is no longer a full-time student. The policy or plan is not required to continue coverage unless the medical necessity of the leave of absence is documented and certified by the attending physician. The coverage continues until the dependent advises the policy or plan that he or she no longer intends to return to school full time, becomes employed full time, obtains other health care coverage, marries and is eligible for coverage as a spouse, reaches an age where he or she is no longer eligible for dependent coverage, or has not returned to school full time after one year since the continuation began or until the coverage of the insured under which the dependent has coverage is discontinued or not renewed. This bill specifies that a policy or plan must continue coverage only if the leave commences while the individual is suffering from a serious illness or injury, the leave is medically necessary, and the leave causes the individual to lose student status. The bill specifies that the physician must also document that the dependent is suffering from a serious illness. The bill requires dependent coverage to continue until the coverage would otherwise end or until one year has elapsed since the continuation began and the dependent has not returned to school full time, and the bill eliminates the other situations under which the continued coverage requirement ends. The bill also requires that every policy and plan provide a description of the continued coverage during a medically necessary leave of absence with any notice regarding a requirement for certification of student status for the dependent's coverage. The dependent whose coverage is being continued during a medically necessary leave of absence is entitled under the bill to the same coverage as a full-time student who is not on leave.

Under current law, an insurer is required to provide consumers policies that are coherent, written in commonly understood language, legible, appropriately divided and captioned, and presented in a meaningful sequence. The commissioner of insurance must make rules establishing standards for the understandability of policies and may exempt types of policies from the specific understandability requirements if the commissioner determines that the type of policy is generally understood by those receiving it or those individuals are adequately protected. This bill additionally requires that, no later than March 23, 2012, each health insurer, health plan, and self-insured governmental health plan comply with the standards that the secretary of the federal DHHS will create regarding compiling and providing a summary of benefits and coverage explanation that accurately describes the benefits and coverage under the plan.

This bill requires that no later than March 23, 2012, every health care plan, except for a grandfathered health care plan, and self-insured governmental health plan must comply with the standards developed by the secretary of the federal DHHS regarding reporting for reimbursement structures to improve health outcomes and other quality measures.

This bill prohibits an insurer or self-insured governmental health plan from imposing a lifetime limit on the dollar value of benefits under the group or individual health care plan or self-insured plan. Before January 1, 2014, an insurer under a group or an individual health care plan, except for a grandfathered health plan providing individual coverage, or a self-insured governmental health plan may impose only a certain annual limit on the dollar value of benefits as defined by the secretary of the federal DHHS. Starting on January 1, 2014, an insurer under a group or individual health care plan, except for a grandfathered health plan providing individual coverage, and a self-insured governmental health plan may not impose an annual limit on the dollar value of benefits.

Under current law, if an insurer provides coverage under a group health benefit plan, the insurer must provide coverage to any eligible employee who becomes an eligible employee after the group coverage commences, and his or her dependents, regardless of health condition or claims experience, with certain exceptions. A self-insured governmental health plan must similarly provide coverage to an eligible employee who waived coverage during an enrollment period, regardless of health condition or claims experience, with certain exceptions. With certain exceptions, under current law, an insurer offering a group health benefit plan must renew coverage at the option of the employer. Current law also requires an insurer that provides an individual health benefit plan to renew the coverage for the insured at the option of the insured, with certain exceptions, but modifications to the individual health benefit plan that comply with the law are allowed. This bill requires any insurer that offers an individual health benefit plan, except for a grandfathered health plan, to offer coverage to any individual, and his or her dependents, that apply for coverage.

Under current law, insurers offering individual or group health insurance policies or plans are not limited in what factors they use to set rates, or premiums, except that they may not discriminate on the basis of race, color, creed, or national origin and they may not under a group health insurance policy or plan charge a higher rate based on a health status-related factor. Rates, under current law, may be modified for individual risks. As of January 1, 2014, health care plans, except for grandfathered health plans, and self-insured governmental health plans, when setting premium rates, may only consider whether the plan covers an individual or a family and the age, tobacco use, and geographic location of any individual covered under the plan. Rates based on age or tobacco use may only vary a certain amount under the bill.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB206, s. 1 Section 1 . 40.51 (8) of the statutes is amended to read:

SB206,6,6 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.723, 632.7252, 632.7254, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.753, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.865, 632.87 (3) to (6), 632.883, 632.885, 632.89, 632.895 (5m) and (8) to (17), and 632.896.

SB206, s. 2 Section 2 . 40.51 (8) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,6,13 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.723, 632.7252, 632.7254, 632.728, 632.746 (1) (1m) to (8) and (10), 632.747, 632.748, 632.753, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.865, 632.87 (3) to (6), 632.883, 632.885, 632.89, 632.895 (5m) and (8) to (17), and 632.896.

SB206, s. 3 Section 3 . 40.51 (8m) of the statutes is amended to read:

SB206,6,19 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.723, 632.7252, 632.7254, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.753, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.865, 632.87 (5m), 632.883, 632.885, 632.89, and 632.895 (11) to (17).

SB206, s. 4 Section 4 . 40.51 (8m) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,7,2 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.723, 632.7252, 632.7254, 632.728, 632.746 (1) (1m) to (8) and (10), 632.747, 632.753, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.865, 632.87 (5m), 632.883, 632.885, 632.89, and 632.895 (11) to (17).

SB206, s. 5 Section 5 . 66.0137 (4) of the statutes is amended to read:

SB206,7,10 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.723, 632.7252, 632.7254, 632.746 (2) (dm) and (10) (a) 2. and (b) 2., 632.747 (3), 632.753, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (4), (5), and to (6), 632.883, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).

SB206, s. 6 Section 6 . 66.0137 (4) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,7,19 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.723, 632.7252, 632.7254, 632.728, 632.746 (2) (dm) (1m) and (10) (a) 2. and (b) 2., 632.747 (3), 632.753, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (4) to (6), 632.883, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).

SB206, s. 7 Section 7 . 120.13 (2) (g) of the statutes is amended to read:

SB206,7,25 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.723, 632.7252, 632.7254, 632.746 (2) (dm) and (10) (a) 2. and (b) 2., 632.747 (3), 632.753, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (4), (5), and to (6), 632.883, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).

SB206, s. 8 Section 8 . 120.13 (2) (g) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,8,7 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.723, 632.7252, 632.7254, 632.728, 632.746 (2) (dm) (1m) and (10) (a) 2. and (b) 2., 632.747 (3), 632.753, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (4) to (6), 632.883, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).

SB206, s. 9 Section 9 . 185.983 (1) (intro.) of the statutes is amended to read:

SB206,8,17 185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.723, 632.7252, 632.7254, 632.745 to 632.749, 632.753, 632.775, 632.79, 632.795, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (2), (2m), (3), (4), (5), and to (6), 632.883, 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:

SB206, s. 10 Section 10 . 185.983 (1) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,9,3 185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.723, 632.7252, 632.7254, 632.728, 632.745 to 632.749, 632.753, 632.775, 632.79, 632.795, 632.798, 632.85, 632.853, 632.855, 632.865, 632.87 (2) to (6), 632.883, 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:

SB206, s. 11 Section 11. 609.22 (3) of the statutes is amended to read:

SB206,9,12 609.22 (3) Primary provider selection. A Except as provided in s. 632.865, a defined network plan that is not a preferred provider plan shall permit each enrollee to select his or her own primary provider from a list of participating primary care physicians and any other participating providers that are authorized by the defined network plan to serve as primary providers. The list shall be updated on an ongoing basis and shall include a sufficient number of primary care physicians and any other participating providers authorized by the plan to serve as primary providers who are accepting new enrollees.

SB206, s. 12 Section 12. 609.845 of the statutes is created to read:

SB206,9,18 609.845 Coverage requirements and limitations; preventive care; maternal and newborn care; quality; standardization. Limited service health organizations, preferred provider plans, and defined network plans are subject to ss. 632.723, 632.7252, 632.7254, 632.746 (2) (dm) or 632.76 (2) (ac) 4., 632.753, 632.865, 632.87 (5m), 632.883, and 632.895 (13m).

SB206, s. 13 Section 13 . 609.845 of the statutes, as created by 2011 Wisconsin Act .... (this act), is amended to read:

SB206,9,25 609.845 Coverage requirements and limitations; preventive care; maternal and newborn care; quality; standardization. Limited service health organizations, preferred provider plans, and defined network plans are subject to ss. 632.723, 632.7252, 632.7254, 632.728, 632.746 (2) (dm) (1m) or 632.76 (2) (ac) 4., 632.7493, 632.753, 632.865, 632.87 (5m), 632.883, and 632.895 (13m).

SB206, s. 14 Section 14. 625.12 (1) (a) and (e) of the statutes are amended to read:

SB206,10,3 625.12 (1) (a) Past and prospective loss and expense experience within and outside of this state, except as provided in s. 632.728.

SB206,10,5 (e) Subject to s. ss. 632.365 and 632.728, all other relevant factors, including the judgment of technical personnel.

SB206, s. 15 Section 15. 625.12 (2) of the statutes is amended to read:

SB206,10,15 625.12 (2) Classification. Risks Except as provided in s. 632.728, risks may be classified in any reasonable way for the establishment of rates and minimum premiums, except that no classifications may be based on race, color, creed or national origin, and classifications in automobile insurance may not be based on physical condition or developmental disability as defined in s. 51.01 (5). Subject to s. ss. 632.365 and 632.728, rates thus produced may be modified for individual risks in accordance with rating plans or schedules that establish reasonable standards for measuring probable variations in hazards, expenses, or both. Rates may also be modified for individual risks under s. 625.13 (2).

SB206, s. 16 Section 16. 625.15 (1) of the statutes is amended to read:

SB206,10,24 625.15 (1) Rate making. An Except as provided in s. 632.728, an insurer may itself establish rates and supplementary rate information for one or more market segments based on the factors in s. 625.12 and, if the rates are for motor vehicle liability insurance, subject to s. 632.365, or the insurer may use rates and supplementary rate information prepared by a rate service organization, with average expense factors determined by the rate service organization or with such modification for its own expense and loss experience as the credibility of that experience allows.

SB206, s. 17 Section 17. 628.34 (3) (a) of the statutes is amended to read:

SB206,11,7 628.34 (3) (a) No insurer may unfairly discriminate among policyholders by charging different premiums or by offering different terms of coverage except on the basis of classifications related to the nature and the degree of the risk covered or the expenses involved, subject to ss. 632.365, 632.728, 632.746 and 632.748. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, blanket or franchise policy, and terms are not unfairly discriminatory merely because they are more favorable than in a similar individual policy.

SB206, s. 18 Section 18. 631.11 (4) (a) and (b) of the statutes are amended to read:

SB206,11,16 631.11 (4) (a) Knowledge when policy issued. No Except as provided in s. 632.753, no misrepresentation made by or on behalf of a policyholder and no breach of an affirmative warranty or failure of a condition constitutes grounds for rescission of, or affects an insurer's obligations under, an insurance policy if at the time the policy is issued the insurer has either constructive knowledge of the facts under s. 631.09 (1) or actual knowledge. If the application is in the handwriting of the applicant, the insurer does not have constructive knowledge under s. 631.09 (1) merely because of the agent's knowledge.

SB206,11,24 (b) Knowledge acquired after policy issued. If Except as provided in s. 632.753, after issuance of an insurance policy an insurer acquires knowledge of sufficient facts to constitute grounds for rescission of the policy under this section or a general defense to all claims under the policy, the insurer may not rescind the policy and the defense is not available unless the insurer notifies the insured within 60 days after acquiring such knowledge of its intention to either rescind the policy or defend against a claim if one should arise, or within 120 days if the insurer determines that it is necessary to secure additional medical information.

SB206, s. 19 Section 19. 631.22 (2) of the statutes is amended to read:

SB206,12,7 631.22 (2) An Subject to s. 632.7252, an insurer may provide a consumer insurance policy which is delivered to a person obtaining insurance coverage and is not exempt under sub. (5) only if the consumer insurance policy is coherent, written in commonly understood language, legible, appropriately divided and captioned by its various sections and presented in a meaningful sequence. The commissioner shall promulgate rules establishing standards for the determination of compliance with this subsection.

SB206, s. 20 Section 20. 631.22 (5) of the statutes is amended to read:

SB206,12,13 631.22 (5) The Except as provided in s. 632.7252, the commissioner may by rule exempt a type of consumer insurance policy from the application of this section if the commissioner finds that type of consumer insurance policy is generally understood by persons to whom it is delivered or that those persons are otherwise adequately protected.

SB206, s. 21 Section 21. 631.95 (3) (a) of the statutes is repealed.

SB206, s. 22 Section 22. 632.723 of the statutes is created to read:

SB206,12,22 632.723 Transparency in coverage. (1) Required information. Except as provided in sub. (4), in addition to other required disclosures, a group or individual health benefit plan, as defined in s. 632.745 (11), shall provide the following information to the secretary of the federal department of health and human services and to the commissioner; provide the following information to any insurance exchange, if the plan is sold through an insurance exchange; and make the following information available to the public:

SB206,12,23 (a) Claims payment policies and practices.

SB206,12,24 (b) Financial disclosures, periodically.

SB206,12,25 (c) Data on enrollment in the plan.

SB206,13,1 (d) Data on disenrollment in the plan.

SB206,13,2 (e) Data on the number of claims that are denied.

SB206,13,3 (f) Data on rating practices.

SB206,13,5 (g) Cost-sharing data and payments with respect to any out-of-network coverage.

SB206,13,6 (h) Enrollee and participant rights.